Language：Japanese   Publisher：日本臨床細胞学会-九州連合会  

子宮頸部腺癌は近年増加傾向にあり,子宮頸部細胞診での早期発見が重要である.子宮頸部の細胞診判定としてはベセスダ分類では,頸管炎や頸管ポリープのような反応性病変から上皮内腺癌(Adenocarcinoma in situ,以下AIS)を含む浸潤腺癌の可能性がある病変までを異型腺細胞(Atypical glandular cells,以下AGC)と判定している.子宮頸部腺系病変におけるAGCの細胞判定について検証した結果,AGCの判定には,集塊の形状,核の重なりなどの細胞配列に加え,核形やクロマチンパターンなどの所見に着目し,可能な限りAGC-favor neoplastic(以下AGC-FN)とAGC-not otherwise specified(以下AGC-NOS)を積極的に活用していくことが重要である.(著者抄録)

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Human Pathology  

Collecting duct carcinoma (CDC) is a rare subset of high-grade renal cell carcinoma (RCC). To diagnose CDC, it is necessary to rule out other renal tumors including renal medullary carcinoma and fumarate hydratase (FH)-deficient RCC. However, there is overlap in the morphology of these three tumors, which all have poor outcomes. There is also still a need to sufficiently examine the therapeutic strategies for each of these tumors. In this study, we retrospectively reclassified invasive/infiltrating high-grade RCC and investigated its pathological features. We reviewed 18 cases previously diagnosed as “CDC,” “FH-deficient RCC,” and “unclassified RCC,” which were reclassified as SMARCB1/INI1-deficient RCC, FH-deficient RCC, and CDC by SMARCB1/INI1, FH, and 2SC immunohistochemistry (IHC) and FH gene mutational status. As the result, 18 cases were reclassified into 2 cases of SMARCB1/INI1-deficient RCC, 7 cases of FH-deficient RCC, and 9 cases of CDC. The morphological features of each group overlapped, and no specific immunohistochemical expression except for SMARCB1/INI1, FH, and 2SC was detected. These results suggest that invasive/infiltrating high-grade RCC should be diagnosed by the combination of immunohistochemistry and molecular biological technique.

DOI： 10.1016/j.humpath.2022.03.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Virchows Archiv  

Intimal sarcoma is one of the most common and well-known primary malignant neoplasms of the aorta and heart. The authors reviewed cases of intimal sarcoma from histological, immunohistochemical and genetic perspectives. Twenty cases of intimal sarcoma were retrieved. Immunohistochemistry and FISH of MDM2 and PDGFRA genes were performed. All 20 tumours were composed of spindle-shaped, stellate, oval or polygonal tumour cells with irregular hyperchromatic nuclei arranged in a haphazard pattern, accompanied by nuclear pleomorphism and frequent mitotic figures. Other histological findings were as follows: abnormal mitosis in 10 cases (50%), necrosis in 15 cases (75%), myxoid stroma in 12 cases (60%), cartilaginous formation in 1 case (5%), haemorrhage in 12 cases (60%) and fibrinous deposition in 14 cases (70%). The tumours were positive for MDM2 in 16 cases (80%), ERG in 4 cases (20%), alpha-smooth muscle actin in 6 cases (30%), desmin in 5 cases (25%) and AE1/AE3 in 4 cases (20%). Immunohistochemical positivity was focal in each case. Loss of H3K27me3 expression was noted in 2 cases (10%). MDM2 and PDGFRA gene amplifications were detected in 11 cases (55%) and 1 case (5%), respectively. Fisher’s exact test revealed a significant correlation between MDM2 gene amplification and myxoid stroma (p = 0.0194). No parameters showed any association with the anatomical location of the tumours. It was suggested that myxoid histology of intimal sarcoma may be associated with MDM2 gene amplification and that intimal sarcoma may be divided into myxoid and non-myxoid types.

DOI： 10.1007/s00428-022-03293-9

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Language：Japanese   Publisher：Japanese Society of Pediatric Cardiology and Cardiac Surgery  

<p>For infants with coarctation of the aorta (COA), either transcatheter balloon angioplasty (BA) or surgical repair is used. COA recurs frequently in low-birth-weight infants who have had either BA or surgical repair. We present a case of a baby girl born at 35 weeks gestational age and weighing 1,374 g who underwent successful surgical repair of COA following palliative BA. A systemic blood pressure gradient of 64 mmHg between the upper and lower limbs was observed at the age of 6 days, confirming the diagnosis of COA. At the age of 25 days, we conducted BA for COA with a minimum diameter of 1.3 mm. Following the placement of a 3-French sheath in the femoral artery, we performed a predilatation with a coronary angioplasty balloon (NC TREK^®2 mm) and a second dilatation with a valvuloplasty balloon (TMP-PED^®4 mm). The systemic blood pressure difference between the upper and lower limbs was reduced to 9 mmHg after successful dilation. As a recurrence of COA developed along with body weight gain, coarctation resection and extended end-to-end anastomosis were performed at the age of 108 days and weight of 3,050 g. At the age of 7 months, there was no recurrence of COA. We believe that delayed surgical repair after palliative BA may be possible in low-birth-weight infants with COA to avoid recurrence of COA.</p>

DOI： 10.9794/jspccs.38.54

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Human Pathology  

Lymphoproliferative disorder (LPD) can occur in patients with inflammatory bowel disease (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). On rare occasions, patients with IBD develop myeloid neoplasms; however, the frequency and clinicopathological features of IBD-associated lymphoid and myeloid proliferative disorder (LMPD) in Japanese patients are still unclear. In this study, we reviewed 2474 Japanese patients with IBD and found that LMPD occurred in 12 (0.5%) patients with UC (n = 7) or CD (n = 5). Together with an additional 3 cases, we analyzed a total of 15 cases of LMPD for clinicopathological and histological features. Based on the status of using immunosuppressants such as biologics and immunomodulators, Epstein–Barr virus (EBV) infection, and histopathology, the 15 cases were classified into Group I (high-grade LPD; n = 7), Group II (low-grade LPD; n = 5), and Group III (myeloid neoplasms; n = 3). Most patients in Group I were undergoing strong immunosuppressive therapy, and the LPD lesions corresponded to high-grade B-cell or T cell/natural killer cell lymphoma often with EBV infection. Discontinuation of immunosuppressive drugs alone did not resolve these LPDs; Group I patients required chemotherapy, and eventually 4 of them (57%) died of the tumor. Most cases in Group II were low-grade B-cell lymphoma without EBV infection and had an indolent clinical course with excellent prognosis. All patients in Group III developed acute myeloid leukemia (AML) during the course of CD. Two (67%) of these patients died of AML. Our study suggests that IBD-associated LMPD is very rare but can follow an aggressive clinical course.

DOI： 10.1016/j.humpath.2021.12.010

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：American Journal of Surgical Pathology  

High-risk human papillomavirus (HPV) infection in conjunctival and lacrimal sac squamous cell carcinomas (SCCs) has been sporadically reported; however, its prevalence, clinicopathologic significance and surrogate markers have not been fully elucidated. Here, we attempted to clarify these questions in Japanese patients with conjunctiva and lacrimal sac SCCs. We retrospectively collected 51 conjunctival SCC and 7 lacrimal sac SCC samples and analyzed them for (1) transcriptionally active high-risk HPV infection using messenger RNA in situ hybridization and (2) protein expressions of p16 and Rb using immunohistochemistry (IHC). Among a total of 58 cases, 25 (43.1%) and 16 (27.6%) tumors were positive for p16-IHC and HPV in situ hybridization, respectively. Ten (19.6%) of the 51 conjunctival SCCs, especially in the palpebral conjunctiva, and 6 (85.7%) of the 7 lacrimal sac SCCs were positive for high-risk HPV. High-risk HPV infection was significantly associated with younger patients, nonkeratinizing SCC histology, p16-positivity and partial loss of Rb expression, but not with recurrence risk. Notably, p16-IHC was not a perfect surrogate marker for high-risk HPV infection; only 64% (16/25) of p16-positive tumors were positive for high-risk HPV. In contrast, the p16+/Rb partial loss pattern was exclusively correlated with high-risk HPV-positivity. The results suggest that the combination of p16 and Rb expression patterns by IHC could be a useful method to predict high-risk HPV infection in conjunctival and lacrimal sac SCCs. HPV infection may be of less prognostic value in this field of cancers.

DOI： 10.1097/PAS.0000000000001857

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00428-021-03189-0

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DOI： 10.1016/j.prp.2021.153668

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DOI： 10.21873/cdp.10051.

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DOI： 10.1016/j.bbrc.2012.09.041

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DOI： 10.1128/MCB.06570-11

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DOI： 10.1111/j.1349-7006.2011.01851.x

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Language：Japanese